Cognitive functioning over 2 years after intracerebral hemorrhage in school-aged children.
Lexa K Murphy, Bruce E Compas, Melissa C Gindville and 2 others
PMID 28877339WHAT IT FOUND
Motor function improved after childhood intracerebral hemorrhage, and some reasoning skills reached average range, but working memory stayed low and processing speed lagged peers.
Motor recovery may mask cognitive needs, so plan serial cognitive testing.
Key findings
01Total Pediatric Stroke Outcome Measure scores improved from 3 months to 24 months, but the median did not change between 12 and 24 months.
02Verbal comprehension improved from the 13th to the 34th centile, perceptual reasoning improved from the 45th to the 63rd centile, and working memory declined from the 16th to the 9th centile.
03Raw working memory scores improved over time, but age-normed centiles declined.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only seven children were included, and no formal statistical testing was done, so the patterns are descriptive and cannot be treated as proof of recovery. The children were aged 6 to 16 years and spoke English as a native language, so the findings may not apply to younger children or children who speak another language. One child had two re-bleeds between the 12- and 24-month follow-ups, and the small sample did not exclude this child, so one child's course can change the group pattern. The same cognitive tests were given at each time point, and practice effects may have inflated scores at 12 months. The study was done at a single tertiary care centre, so it may not reflect other settings.
The easy way to misread this
Do not conclude that children recover neurologically and then need no further cognitive support. Motor and some reasoning scores improved, but working memory centiles declined and remained low, and no formal statistical testing was done.